Provider Demographics
NPI:1114967072
Name:DAUERMAN, REBECCA LYNN (APN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:DAUERMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MALAPARDIS ROAD
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927
Mailing Address - Country:US
Mailing Address - Phone:973-605-5000
Mailing Address - Fax:973-898-9305
Practice Address - Street 1:201 MALAPARDIS ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927
Practice Address - Country:US
Practice Address - Phone:973-605-5000
Practice Address - Fax:973-898-9305
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09255500163WP0808X
NJ26NC09255500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health